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Psychology 2310A/B
Rod Martin

Schizophrenia and Other Psychotic Disorders Introduction to Schizophrenia Psychotic disorder • Out of touch with reality Most severely debilitating of mental disorders Most patients unable to care for themselves • Cant hold down jobs and even basic care like hygiene and cooking • 40-60% live with family members • others are hospitalized or homeless 10% - 20% of homeless people Begins early in life (age 16-25) Long-term disability Suicide rates 8% - 10% 2x as common asAlzheimer’s, 5x MS Cystic fibrosis (Shinerama) – 300x 300,000 Canadians - 1 / 12 hospital beds Huge health care and social costs Estimated $6.85 billion annually in Canada Amajor world-wide health problem. • Hallucinations- hearing voices • Delusions- false beliefs Eugene Bleuler • coined the term “schizophrenia, literally means split mind • his term led to the conception that it is like multiple personality but it is not • focused more on cognitive aspects, saw it as a cognitive disorder, agreed there was a biological basis but also psychological and environmental factors • disordered thinking process • biology-environment interaction • believed recovery is possible • on going debate- is purely biological disease of the brain or an interactions between psychological and bio Symptoms of Schizophrenia Disordered Thinking (Speech) • incoherence- really hard to understand them • the way this becomes observable is through their speech “Formal thought disorder” Incoherence - “Word salad”: in severe cases, speak but it is just a lot of different words jumbled together but they don’t make sense • when they are talking but they don’t make sense Neologisms: made up words that don’t exist that are thrown into their text *EXAM ex. Cosmo blue Loose associations- word associations- jumps from one thought to another Perseveration – person gets stuck on one line of thinking and can’t shift to another thought, coming back to the same topic Poverty of speech- alogia, lack of words, almost must Thought blocking.- suddenly their thoughts disappear from mind Delusions Delusions Reference, grandeur, control, persecution, somatic Thought insertion Thought broadcasting Thought withdrawal Hallucinations Most commonly auditory Disorganized Motor Behavior Disorganized behaviour- on the move, out of control, sometimes violent Catatonic immobility – “waxy flexibility”.- Still, not moving, immobile, curl up in a fetal position or even standing up and do posturing- stand in a pose for a long period of time - this is just a way of control all these excessive input. So if you want to block it out by withdrawing completely and becoming immobile Negative Symptoms Alogia – poverty of speech Anhedonia – loss of pleasure Diminished emotional expression – flat affect Avolition – lack of motivation Social withdrawal Less response to antipsychotic meds DSM-IV Diagnosis of Schizophrenia Prodromal, active, and residual phases Prodromal – clear deterioration of functioning Active phase involves 2 or more symptoms: Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms Only 1 symptom if: (1) bizarre delusions, or (2) auditory hallucination of voice keeping running commentary, or (3) two or more voices conversing Residual – attenuated symptoms following active phase Active phase lasts at least 1 month All phases last at least 6 months If less than 6 months: Schizophreniform Disorder (1-6 months) Brief Psychotic Disorder ( < 1 month) Social and occupational dysfunction. All phases COMBINED last at least 6 months If less than 6 months: Scizophreniform Disorder (1-6 months)- they’ll be hospitalized and be monitored, given treatment but if symptoms continue for more than 6 months, then diagnostic will be changed to Schizophrenia - same medication as schizophrenia - brief psychotic disorder (< 1 month)- psychotic breakdown overwhelmed, they have psychotic symptoms. Some people will recover and it can never happen again. Subtypes of Schizophrenia Paranoid Type Delusions, auditory hallucinations No disorganized speech, behavior, or affect Most common, least severe type Don’t have any negative symptoms Disorganized Type Disorganized speech, behavior; inappropriate affect - act in a really strange way -
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